First came the jihadist leader seeking treatment. Then came the guards with thieves whose hands needed cutting off.

FILE - In this Jan. 31, 2013 file photo, Issa Alzouma, 39, poses in front of his home in Gao, northern Mali, Thursday, Jan. 31, 2013. Alzouma's arm was amputated by Islamist radicals on Dec. 21, 2012, after an Islamic tribunal charged him with spying. Alzouma, a father of three, denied the charges, and said he was just changing the faulty plug on his motorcycle's engine alongside the road. The extremists fled the city Saturday as French, Chadian and Nigerian troops arrived, ending 10 months of radical Islamic control over the city. But the intervention came too late for Alzouma and the other men who lost their hands and probably their livelihoods, too, when the militants carried out amputations as punishments for theft and other alleged crimes under their strict interpretation of Shariah, or Islamic law. (AP Photo/Jerome Delay, File)
Associated Press

As international terrorists go, Mokhtar Belmokhtar has built an impressive résumé. The Algerian-born Islamist began his career in Afghanistan in the early 1990s before going on to lead a unit of al Qaeda in the Maghreb. His most recent splinter group, which calls itself Those Who Sign in Blood, was responsible for last month's bloody hostage crisis at the In Amenas gas plant in Algeria.

He spent much of the past year moving from safe house to safe house here in Gao, northern Mali's largest city, which jihadists controlled until the French arrived in January. The kill-list candidate, smuggler and prolific kidnapper is now a key target of the French terrorist-hunt in the Ifoghas Mountains.

But to Dr. Abdoulaziz Maiga, a family practitioner and aspiring surgeon at the Hospital of Gao, Belmokhtar is just another patient.

"Belmokhtar—it's complicated," Dr. Maiga said with a sigh last week when I visited his office. "Yes, I saw him—sometimes he came to the hospital, and sometimes we went to his house. But it was purely medical."

A rock holds up one corner of Dr. Maiga's desk and he swats at the occasional fly. After nearly a year of fighting and jihadist occupation, he is one of only 13 physicians still in Gao and its environs, serving a population of nearly half a million. Having attended university in Bamako, the 29-year-old Gao native has been practicing medicine here since 2011. His motivation, he says, is to "help people and save lives, like any other doctor." Any other doctor, that is, until the jihadists came to town.

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'I dance in my office,' says Dr. Maiga, at the Hospital of Gao last week.
Anne Jolis for The Wall Street Journal

Pressed for details, Dr. Maiga says only that Belmokhtar "was very nice, very educated, very calm. He didn't even speak. He had someone else speaking for him—he doesn't speak French. He always had a lot of people with him, many people."

The day before our interview, some locals had taken me to one of the houses where they say Belmokhtar had stayed for a few weeks. The dwelling has since been sacked by the Malian army, but telltale Islamist symbols remain chalked on the walls and a smorgasbord of empty pharmaceutical packaging litters the yard. These include intravenous sodium lactate, which could treat acidosis; sodium chloride and glucose; and metronidazole, an antibiotic that could treat any number of infections.

I read out the list of drugs I found at the house and ask Dr. Maiga if he had prescribed them to the terrorist or his entourage. But the doctor won't budge: "It's medical—it's confidential." If anyone is searching for jihadists, he adds, "Go look for them in the bush. Don't ask me."

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Some of the drugs found at one of terrorist Mokhtar Belmokhtar's alleged safe houses in Gao, Mali.
Anne Jolis for The Wall Street Journal

It sounds as though Dr. Maiga is protecting his murderous patient, and if so, it's understandable. After a military coup took down Mali's government last March, Gao's local officials were the first to flee, leaving the town in the hands of nationalist Tuareg rebels and, by the summer, an al Qaeda-linked group known as the Movement for Oneness and Jihad in West Africa, or Mujao. The locals here describe Mokhtar Belmokhtar as a "spiritual leader" to Mujao.

"Once they took control of the city, they brought in their own administrators," Dr. Maiga recalls of Mujao. "They were staying here in the hospital, they were running the hospital, about four or five of them."

He admits that he treated other jihadists during the occupation but again cites "patient confidentiality" when asked for specifics. Like every other resident of Gao with whom I spoke, Dr. Maiga doesn't really believe the jihadists have gone anywhere.

"Mujao is very powerful," he says. "They're strong and they're dangerous. With all that we've survived here, no one feels secure. Even with the French here, they're still capable of doing things."

As if to prove his point, an estimated 20-30 Mujao fighters launched an attack from within the center of Gao on Feb. 21, armed with Kalashnikovs, machine guns, rockets and homemade bombs. Their urban-guerrilla combat held up French and Malian forces for more than six hours and destroyed downtown Gao before the French finally drove them out. Some of the Malian soldiers ran out of ammunition before the jihadists did.

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Malians whose hands were cut off during a brutal jihadist occupation of the city. One of the men holds a black hood that he said the jihadists wore in action.
Anne Jolis for The Wall Street Journal

It's not hard to see why Dr. Maiga does "not have confidence" in French talk of an imminent troop drawdown—and why he might dread that development. If the jihadists ever manage to retake Gao, it will likely mean a return to the most harrowing period of the doctor's professional life.

When Mujao ruled the town, the jihadists imposed the strictest Shariah law, complete with hand amputations for thieves and other petty criminals.

At that point, Dr. Maiga says, he was given an ugly job: assisting in the dismemberment.

"They came to us and they said, 'This is Shariah, it's the will of God,' and they asked me to cut people's hands off." It turns out that chopping off appendages isn't the simple justice it sounds like. Done incorrectly, the amputees will bleed to death—a punishment too far, apparently, even for the al Qaeda-brand penal code.

Dr. Maiga recounts his attempts to refuse. "I said, 'Wait, no, I can't.' When I amputate a limb, it's because it's gangrenous or doesn't work right. But when it's viable, I can't cut it. I told them, 'This is your Shariah, it's not my thing—it's nothing to do with medicine.' "

The jihadists soon found an arrangement anyway: Mujao would conduct its own amputations, staunch the wounds and bring the victims to the hospital. There, Dr. Maiga would finish the job—cut enough flesh so that the amputees could later receive prosthetics, dress the wounds properly so the stumps wouldn't bleed out, and administer painkillers.

"It was very hard," he says quietly. "I never thought that one day I would treat an arm that wasn't diseased. But I had to look at it from both sides: Of course, this was not good, not good at all. On the other side, these people were suffering and if we didn't deal with it, they'd die, they'd bleed to death. We didn't have a choice, we had to treat them."

It's getting late and our interview is running up against Gao's nighttime curfew. As Dr. Maiga and I approach the hospital gates, I ask on a whim if there's anywhere to go dancing in Gao. Before the coup, the city was dotted with nightclubs and bars blaring desert reggae. They're now gutted and abandoned, after the jihadists shuttered them at gunpoint last year.

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